18F-氟脱氧葡萄糖正电子发射断层扫描参数对胆道癌患者预后的意义：一项荟萃分析。

Prognostic significance of 18F-Fluorodeoxyglucose positron-emission tomography parameters in patients with biliary tract cancers: a meta-analysis.

机构信息

Oncology Department, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, No.155 Hanzhong Avenue, Nanjing, 210000, China.

Dermatology Department, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, No.155 Hanzhong Avenue, Nanjing, 210000, China.

出版信息

BMC Med Imaging. 2024 Jan 2;24(1):9. doi: 10.1186/s12880-023-01182-4.

DOI:10.1186/s12880-023-01182-4

PMID:38166643

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10763065/

Abstract

BACKGROUND AND OBJECTIVE

Numerous previous studies have assessed the prognostic role of 18F-fluorodeoxyglucose positron-emission tomography (18F FDG PET) in patients with biliary tract cancer (BTC), but those results were inconsistent. The present study aims to determine the predictive value of 18F FDG PET in BTC patients via a meta-analysis.

METHODS

The underlying studies related to 18F FDG PET and BTC patients` outcomes were searched and identified in the online databases. The interested parameters include total lesion glycolysis (TLG), metabolic tumor volume (MTV), primary tumor and metastatic lymph node (LN) maximum standardized uptake value (SUVmax), as well as change of SUVmax (ΔSUVmax) during treatment. Overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) were considered as the primary endpoints. Hazard ratio (HR) and corresponding 95% confidence intervals (CIs) were defined as the effective measure and calculated by a pooled analysis. Publication bias was assessed by funnel plot, Bagg's and Egger's tests.

RESULTS

Totally, 23 studies involving 1478 patients were included in the present meta-analysis. After a pooled analysis, it revealed that a high SUVmax was significantly associated with a poor OS (HR:2.07, 95%CI: 1.74-2.46, P = 0.000) and DFS (HR: 2.28, 95%CI: 1.53-3.41, P = 0.000). In addition, an increased TLG level contributed to a shorter OS (HR:1.91, 95%CI: 1.26-2.90, P = 0.002) and DFS (HR: 4.34, 95%CI: 1.42-13.27, P = 0.01). Moreover, we confirmed that an elevated MTV was significantly associated with increased mortality (HR:2.04, 95%CI:1.26-3.31, P = 0.004) and disease relapse (HR: 3.88, 95%CI:1.25-12.09, P = 0.019) risks. Besides, the present study uncovered that increased ΔSUVmax could predict poor OS (HR:1.26, 95%CI:1.06-1.50, P = 0.008) instead of PFS (HR: 1.96, 95%CI: 0.82-4.72, P = 0.280). Lastly, we found that LN SUVmax did not link to OS (HR: 1.49, 95%CI: 0.83-2.68, P = 0.178). No obvious publication bias was detected in the present study.

CONCLUSION

18F FDG PET parameters, including SUVmax, TLG, MTV, and ΔSUVmax, could be applied as convenient and reliable factors for predicting BTC patients` outcomes.

摘要

背景与目的

已有大量研究评估了 18F-氟脱氧葡萄糖正电子发射断层扫描（18F FDG PET）在胆道癌（BTC）患者中的预后作用，但结果并不一致。本研究旨在通过荟萃分析确定 18F FDG PET 在 BTC 患者中的预测价值。

方法

在在线数据库中搜索并确定了与 18F FDG PET 和 BTC 患者结局相关的基础研究。感兴趣的参数包括总病灶糖酵解（TLG）、代谢肿瘤体积（MTV）、原发肿瘤和转移性淋巴结（LN）最大标准化摄取值（SUVmax），以及治疗期间 SUVmax 的变化（ΔSUVmax）。总生存期（OS）、无病生存期（DFS）和无进展生存期（PFS）被视为主要终点。风险比（HR）和相应的 95%置信区间（CIs）被定义为有效衡量标准，并通过汇总分析进行计算。使用漏斗图、Bagg's 和 Egger's 检验评估发表偏倚。

结果

共有 23 项研究纳入了 1478 名患者，纳入本荟萃分析。经过汇总分析，结果表明高 SUVmax 与较差的 OS（HR：2.07，95%CI：1.74-2.46，P=0.000）和 DFS（HR：2.28，95%CI：1.53-3.41，P=0.000）显著相关。此外，TLG 水平升高与 OS（HR：1.91，95%CI：1.26-2.90，P=0.002）和 DFS（HR：4.34，95%CI：1.42-13.27，P=0.01）缩短有关。此外，我们证实升高的 MTV 与死亡率（HR：2.04，95%CI：1.26-3.31，P=0.004）和疾病复发（HR：3.88，95%CI：1.25-12.09，P=0.019）风险增加显著相关。此外，本研究发现升高的 ΔSUVmax 可预测较差的 OS（HR：1.26，95%CI：1.06-1.50，P=0.008），而不是 PFS（HR：1.96，95%CI：0.82-4.72，P=0.280）。最后，我们发现 LN SUVmax 与 OS 无关（HR：1.49，95%CI：0.83-2.68，P=0.178）。本研究未发现明显的发表偏倚。